Public Health Reports[JOURNAL]
Sun
200 papers
Hepatitis C Surveillance in the United States: Past, Present, and Future.
Barker LK, Doshani M, Jiles RB … +1 more , Teshale E
Public Health Rep · 2025 Aug · PMID 40874425 · Full text
Data from 3 US public health surveillance systems indicate that an estimated 67 400 people acquired hepatitis C virus infections in 2022, 2.2 million adults had hepatitis C during January 2017-March 2020, and 12 717 peop...
Data from 3 US public health surveillance systems indicate that an estimated 67 400 people acquired hepatitis C virus infections in 2022, 2.2 million adults had hepatitis C during January 2017-March 2020, and 12 717 people died in 2022 from hepatitis C-related causes, despite the availability of curative treatment since 2013. The 3 surveillance systems that provided these data-the National Notifiable Diseases Surveillance System, the National Health and Nutrition Examination Survey, and the National Vital Statistics System-were selected to monitor progress toward elimination of hepatitis C as a public health threat in the United States by 2030. However, some limitations of these surveillance systems compel the use of additional data sources with more timely information for the general population and for populations with higher incidence, prevalence, or mortality of hepatitis C, such as those experiencing homelessness, incarceration, or injection drug use. Commercial laboratories, health systems, and programs serving these populations could provide such data. This topical review of hepatitis C surveillance describes the history, long-term trends, and recent investments in public health surveillance for hepatitis C. Strengthening and modernizing the hepatitis C surveillance workforce and systems, improving data system interoperability, linking complementary data sources, and leveraging multiple data systems can aid in the measurement of public health efforts to meet hepatitis C elimination goals.
Access to and Satisfaction With Children's Mental Health Treatment in the United States.
Sappenfield OR, Ghandour RM, Lebrun-Harris LA
Public Health Rep · 2025 · PMID 40874413 · Full text
OBJECTIVES: Many children with a mental health condition do not receive mental health treatment, and access differs across sociodemographic characteristics. The objective of this study was to assess the need for, receipt...
OBJECTIVES: Many children with a mental health condition do not receive mental health treatment, and access differs across sociodemographic characteristics. The objective of this study was to assess the need for, receipt of, difficulty obtaining, and satisfaction with children's mental health treatment among US households with children. METHODS: We analyzed data collected from June 7 through August 7, 2023, from the Household Pulse Survey. The sample included 66 611 households with children aged 0 to 17 years, with 53 842 households answering questions about children's mental health treatment needs. We defined the terms "need," "receipt," "difficulty getting treatment," and "satisfaction." We estimated the prevalence of treatment needs overall and by number of children in the household, children's ages, respondent characteristics, and annual household income. Analyses incorporated replicate weights. RESULTS: About 17% of households with children reported that some or all children needed mental health treatment; of these, 70% reported that all children received needed treatment. About 62% of households reported some difficulty getting treatment, and about 37% were dissatisfied with at least some of the treatment received. The prevalence of need for, receipt of, difficulty obtaining, and satisfaction with mental health treatment differed across covariates, in particular, children's ages; respondent race, ethnicity, and health insurance; and annual household income. CONCLUSIONS: There are unmet needs for children's mental health treatment, a high prevalence of difficulty obtaining treatment, and dissatisfaction with treatment when obtained. Future research should investigate the barriers to receiving timely mental health treatment and reasons for dissatisfaction with care.
Influence of a Pandemic on an Epidemic: A Population-Based Ecological Study of the Association Between COVID-19 Diagnoses and Drug Overdose Deaths in Rhode Island, 2023.
Carrara RL, Goedel WC, Pratty C … +4 more , Chambers LC, Hallowell BD, Bowman S, Marshall BDL
Public Health Rep · 2025 · PMID 40852798 · Full text
OBJECTIVES: In Rhode Island, drug overdose deaths increased by 28% in the first 6 months of the COVID-19 pandemic in 2020 as compared with the previous year (2019), mirroring national trends. We explored how the spatial...
OBJECTIVES: In Rhode Island, drug overdose deaths increased by 28% in the first 6 months of the COVID-19 pandemic in 2020 as compared with the previous year (2019), mirroring national trends. We explored how the spatial distribution of overdose deaths overlapped with that of COVID-19 cases to identify levels and increased prevalence of these health issues among census tracts in Rhode Island. METHODS: We used data from the Rhode Island Department of Health and the US Census Bureau to calculate annualized COVID-19 case rates (from March 20, 2020, through December 31, 2021) and unintentional overdose death rates by census tract (from January 1, 2018, through December 31, 2021). We used bivariate cluster analyses to group census tracts into clusters of high-high, low-low, high-low, and low-high overdose deaths and COVID-19 case rates per 100 000 population. RESULTS: Clusters with high overdose death rates and high COVID-19 case rates were identified in urban census tracts around the capital city of Providence, whereas clusters with low overdose death rates and low COVID-19 case rates were identified in the state's southern census tracts. Structural factors differed among cluster groups: cluster groups with high overdose death rates and high COVID-19 case rates had greater percentages of households with overcrowding (mean [SD] = 1.6% [1.0%]), people living below the federal poverty level (17.5% [7.4%]), and people with a high school degree or less (37.8% [7.8%]) than the other cluster groups. CONCLUSIONS: Targeted investments in community-led and place-based public health interventions can be used to address underlying social and structural determinants of health (eg, overcrowding, poverty, low education levels) in communities with high rates of overdose deaths and COVID-19 cases.
Relationship Between Number of Older Siblings and Common Cold Among Children Aged 5 Years: The Kyushu Okinawa Maternal and Child Health Study.
Kihara H, Miyake Y, Tanaka K
Public Health Rep · 2025 · PMID 40852737 · Full text
OBJECTIVES: In view of the lack of epidemiologic information on the relationship between sibship size and the common cold, this prebirth cohort study investigated the association between the number of older siblings and...
OBJECTIVES: In view of the lack of epidemiologic information on the relationship between sibship size and the common cold, this prebirth cohort study investigated the association between the number of older siblings and the high frequency of common colds in Japanese children aged 5 years. METHODS: The study included 1197 mother-child pairs in the Kyushu Okinawa Maternal and Child Health Study; data were collected through questionnaires. From April 2007 through March 2008, the baseline survey, conducted during pregnancy, collected information on the number of children (older siblings). The questionnaire in the eighth survey (at approximately 60 months postpartum) asked participants about the frequency of common colds in their children since their fourth birthday. We defined high frequency of common colds as experiencing ≥6 common colds since turning age 4 years. RESULTS: Among the 1197 children aged 59 to 71 months, 140 (11.7%) experienced a high frequency of common colds. Compared with having no older siblings, having 1 older sibling and having ≥2 older siblings were independently associated with a lower likelihood of high frequency of common colds at age 5 years. The adjusted odds ratios (95% CI) for high frequency of common colds were 0.67 (0.45-0.99) for 1 older sibling and 0.42 (0.23-0.73) for ≥2 older siblings ( for trend = .001), using no older siblings as the reference group. CONCLUSIONS: This study identified an independent inverse exposure-response relationship between the number of older siblings and high frequency of common colds at age 5 years. Given that the sibling effect is beneficial for colds, it may be necessary to focus on preventing colds in the first child.
Comparison of the Social Vulnerability Index, Area Disadvantage Index, and Social Deprivation Index for Adults With Out-of-Hospital Emergencies.
Ramgopal S, Crowe RP, Misra AJ … +1 more , Cash RE
Public Health Rep · 2025 · PMID 40842234 · Full text
OBJECTIVES: Multiple measures are used to assess neighborhood disadvantage. Although each was created with a unique purpose, they share conceptual and methodological overlap. We examined the correlation among 3 measures...
OBJECTIVES: Multiple measures are used to assess neighborhood disadvantage. Although each was created with a unique purpose, they share conceptual and methodological overlap. We examined the correlation among 3 measures of neighborhood disadvantage (Social Vulnerability Index [SVI], Area Disadvantage Index [ADI], and Social Deprivation Index [SDI]) and their association with quality indicators for adults with prehospital emergencies. METHODS: We performed a retrospective analysis using a national multiagency emergency medical services (EMS) database, including emergency scene encounters for adults (aged ≥18 y) with available census-tract SDI and SVI data and census-block ADI data from January 1 through December 31, 2023. We compared the SVI, ADI, and SDI using overall and pairwise intraclass correlation coefficients (ICCs). We evaluated the association of each index with 7 quality indicators for prehospital care developed by the National EMS Quality Alliance. RESULTS: We included 9 259 983 encounters (median [IQR] age, 63 [44-77] y). The overall ICC between indices was 0.65, indicating moderate agreement. We found higher agreement between SVI and SDI (ICC = 0.84) than between SVI and ADI (ICC = 0.54) or ADI and SDI (ICC = 0.59). We found overlap among the indices for most outcomes, although we found differences in ADI associations compared with SVI and SDI for some outcomes. These included bronchodilator use in asthma (SDI/SVI positively associated, ADI not associated), treatment of hypoglycemia (ADI negatively associated, SDI/SVI not associated), and screening of suspected stroke (SDI/SVI negatively associated, ADI not associated). CONCLUSIONS: We found moderate agreement among 3 commonly used indices of neighborhood disadvantage. Research is needed to refine the application of these indices to prehospital care and explore their utility in reducing health disparities across health care settings.
Asthma and Allergy Comorbidity Among the US Population Aged 2 Years or Older, National Health Interview Survey, 2021.
Pate CA, Akinbami LJ, Johnson C … +2 more , Hsu J, Zahran HS
Public Health Rep · 2025 · PMID 40842192 · Full text
OBJECTIVES: Asthma has substantial morbidity and impact on quality of life. Symptoms can worsen when asthma coexists with allergy. We assessed the prevalence of asthma-allergy comorbidity in a nationally representative s...
OBJECTIVES: Asthma has substantial morbidity and impact on quality of life. Symptoms can worsen when asthma coexists with allergy. We assessed the prevalence of asthma-allergy comorbidity in a nationally representative sample. METHODS: We used 2021 National Health Interview Survey data for 7343 children and adolescents aged 2 to 17 years and 29 329 adults aged ≥18 years to estimate the prevalence of asthma, allergy symptoms, and lifetime allergy diagnosis. We assessed associations between asthma-allergy comorbidity and characteristics (sex, age group, race and ethnicity, family income, region, urbanicity) and between asthma attacks and allergy by using logistic regression. RESULTS: Almost 8% of people aged ≥2 years had asthma, and 52.3% had allergy symptoms. Among children and adolescents, boys had a higher prevalence of asthma-allergy comorbidity than girls (6.2%; 95% CI, 5.3%-7.2% vs 5.0%; 95% CI, 4.2%-5.9%). Among adults, men had a lower prevalence of asthma-allergy comorbidity than women (4.9%; 95% CI, 4.5%-5.4% vs 8.3%; 95% CI, 7.7%-8.8%). The prevalence of asthma-allergy comorbidity was higher among people with low income (<100% vs ≥200% federal poverty level) and non-Hispanic Black (vs non-Hispanic White) people. Among people with asthma, 82.1% had allergy symptoms and 67.3% had a lifetime allergy diagnosis. The prevalence of allergy symptoms differed by sex among adults with asthma but not among children and adolescents with asthma. Among adults with asthma, asthma attacks were associated with allergy symptoms (adjusted prevalence ratio = 1.23; 95% CI, 1.04-1.46). CONCLUSION: Disparities in asthma-allergy comorbidity exist by sex, family income, and race and ethnicity. These findings support national asthma management guidelines on the importance of identifying and treating comorbid allergies among people with asthma.
Perceived Income Adequacy Versus Household Income as a Measure of Socioeconomic Status in 6 Countries, 2022-2023 International Food Policy Study.
Acton RB, White CM, Rynard VL … +1 more , Hammond D
Public Health Rep · 2025 · PMID 40832816 · Full text
OBJECTIVES: Household income is a common indicator of socioeconomic status in population surveys; however, measures such as perceived income adequacy are increasingly used as alternatives. We used a multicountry dataset...
OBJECTIVES: Household income is a common indicator of socioeconomic status in population surveys; however, measures such as perceived income adequacy are increasingly used as alternatives. We used a multicountry dataset to explore the utility of perceived income adequacy as compared with household income, focusing on missing data rates, associations with household food security, and responses from young people versus parents. MATERIALS AND METHODS: We conducted online surveys in 2022-2023 among adults (n = 50 913) and young people (aged 10-17 y; n = 23 013) as part of the International Food Policy Study in Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. We used descriptive analyses to examine missing data for income adequacy and household income adjusted for household size. We used linear regression models to test the association between the income measures, their associations with household food security, and their correspondence in reported income adequacy between young people and parents. RESULTS: The proportion of missing data was greater for household income (5.3%; n = 2688) than for income adequacy (1.0%; n = 488). Income adequacy and household income were positively correlated ( = 0.25-0.44; < .001 for all countries). Both measures independently predicted household food security ( < .001 for all countries), with a stronger association observed for income adequacy. Family income adequacy reported by young people was strongly associated with parental reports ( = 0.47-0.62; < .001 for all). PRACTICE IMPLICATIONS: Perceived income adequacy may be preferrable to traditional household income measures for assessing the effect of financial position on health-related outcomes, particularly among young people and older or retired populations, for whom household income may be difficult to report.
The Challenge of Long COVID: Is the Pandemic Really Over?
Levin J, Bradshaw M
Public Health Rep · 2025 · PMID 40819231 · Full text
Sequelae of SARS-CoV-2 infection began appearing among patients who had COVID-19 within months of the first wave of the COVID-19 pandemic in 2020. This phenomenon, termed and also known as , has been a source of controv...
Sequelae of SARS-CoV-2 infection began appearing among patients who had COVID-19 within months of the first wave of the COVID-19 pandemic in 2020. This phenomenon, termed and also known as , has been a source of controversy among physicians, as presentation of long COVID has been a somewhat mysterious constellation of signs and symptoms that seem mostly impervious to efficacious treatment. Although a considerable amount has been learned about the pathophysiology and other biomedical features of long COVID, the epidemiologic parameters of long COVID, including incidence and prevalence, are uncertain in the United States and globally. The best estimates are that millions of people have long COVID. Despite the declining incidence of COVID-19, the low case fatality of long COVID suggests that its prevalence is poised to continue to grow. This increasing prevalence of long COVID presents a challenge for the public health sector. Here, we examine the public health implications of long COVID. We offer policy recommendations, including ending congratulatory talk that the pandemic is over, encouraging more focused attention from the United States and global nongovernmental organizations, and establishing a multinational research initiative to better understand and respond to long COVID and other postviral and postinfectious chronic conditions. Although COVID-19 may not be as widespread and disruptive as in the early months of the pandemic, it would be a mistake to presume that, because the acute crisis is behind us, the pandemic is past. Long COVID is an ongoing public health threat and merits our concern.
Leveraging State-Supported Continuing Education for Health Care Professionals to Address Public Health Priorities: A 5-Year Retrospective Case Study on the District of Columbia Program.
Downing G, Mayewski Z, Tramontozzi LM … +2 more , Plotke M, Ortique J
Public Health Rep · 2025 · PMID 40819228 · Full text
This case study explores the development, implementation, and outcomes of an innovative public health continuing education program designed by the District of Columbia Department of Health to align health care profession...
This case study explores the development, implementation, and outcomes of an innovative public health continuing education program designed by the District of Columbia Department of Health to align health care professionals' education with public health priorities. The District of Columbia Center for Rational Prescribing program released high-quality accessible education to health care professionals from October 2020 through July 2024. With 15 504 enrollments and a 71.9% completion rate, the program demonstrated substantial engagement of health care professionals. Additionally, of the 10 824 participants who completed a postcourse survey, 90.8% agreed or strongly agreed that the courses enabled them to make key decisions in their practice. These findings indicate not only that the program attracted many participants but also that state-supported topics were highly relevant and applicable to the professionals' practices, equipping them with tools to tackle public health issues in their communities.
Telehealth Use in Medicaid: Implications for Quality Care for Individuals With ADHD and Tourette Syndrome.
Karacuschansky A, Organick-Lee P, Horton K … +1 more , Seiler N
Public Health Rep · 2025 · PMID 40819227 · Full text
The expansion of telehealth during the COVID-19 pandemic transformed behavioral health care delivery, including for individuals with attention-deficit/hyperactivity disorder (ADHD) and Tourette syndrome (TS), conditions...
The expansion of telehealth during the COVID-19 pandemic transformed behavioral health care delivery, including for individuals with attention-deficit/hyperactivity disorder (ADHD) and Tourette syndrome (TS), conditions that require ongoing treatment and monitoring. We explored the implications of telehealth on the quality of care for Medicaid beneficiaries with ADHD and TS, highlighting the benefits, challenges, and policy considerations. Telehealth has increased access to behavioral health services, including for ADHD and TS, by reducing geographic and financial barriers to care. The expanded use of telehealth has allowed patients to more easily interact with health care providers, and it particularly benefits those with limited access to specialized care. However, challenges remain, such as concerns about stimulant misuse in online ADHD treatments and the limited privacy offered in home telehealth settings. Furthermore, disparities in broadband access may exacerbate existing inequalities in care. Despite telehealth's potential to increase access to specialized care, the quality of telehealth provided is not guaranteed. Current quality measures for Medicaid telehealth services, especially for ADHD and TS, are insufficient. While some Medicaid programs have integrated telehealth into quality reporting, a need exists for more tailored measures that assess the unique needs of people with ADHD and TS. We recommend the development of quality measures for ADHD and TS, performance improvement projects for these conditions, better alignment of Medicaid managed care oversight, and research into the long-term outcomes of telehealth for care of people with ADHD and TS. Such efforts would support continued Medicaid telehealth expansion while ensuring high-quality care.
Most Common Causes of Death Among Travelers on Aircraft and Maritime Vessels and During Land-Border Crossings Reported to the Centers for Disease Control and Prevention, 2008-2022.
Preston LE, King J, Ortiz N … +12 more , Alvarado-Ramy F, Brown C, Mase S, Gearhart SL, Christensen DL, Pourakis GA, Fonseca-Ford M, Rothney EE, Sunavala ZK, Swisher SD, Hausman L, Gertz AM
Public Health Rep · 2025 · PMID 40788110 · Full text
OBJECTIVES: Historically, the most frequent cause of death reported to the Centers for Disease Control and Prevention (CDC) among travelers on conveyances has been cardiovascular disease, mirroring all-cause mortality in...
OBJECTIVES: Historically, the most frequent cause of death reported to the Centers for Disease Control and Prevention (CDC) among travelers on conveyances has been cardiovascular disease, mirroring all-cause mortality in the US population. Infectious disease transmission, particularly during large-scale outbreaks, also poses a risk to travelers. To determine leading causes of death on conveyances and whether they were affected by the COVID-19 pandemic, we describe causes of death on conveyances reported to CDC from 2008 through 2022. METHODS: We queried CDC's Port Health Activity Reporting System for traveler deaths on, or immediately after disembarking from, an aircraft or maritime vessel or during land-border crossings reported to CDC from July 1, 2008, through December 31, 2022. We examined data on cause of death, age, travel mode, and traveler type (passenger vs crew). We also calculated crude annual mortality rates for each conveyance type. To assess factors associated with deaths due to infectious diseases (vs deaths due to noninfectious conditions), we performed logistic regression. RESULTS: During the analysis period, 2910 deaths on conveyances were reported. Across all conveyances, the most common causes were cardiovascular- or pulmonary-related conditions (2116 of 2910; 73%) for each year except 2020, when COVID-19 was the most common. Crew (vs passengers) had significant associations with death due to infectious causes (vs noninfectious causes; adjusted odds ratio = 2.12; 95% CI, 1.32-3.40). CONCLUSIONS: Travelers with cardiovascular- or pulmonary-related conditions should consult their health care providers prior to international travel. All travelers should check travel recommendations such as those currently available on CDC travel pages. Public health authorities should consider population-based mitigation measures aimed at transmission risk reduction to limit morbidity and mortality during infectious disease outbreaks.
Using Pandemic-Era Longitudinal Surveillance Data to Improve Investigations of Carbapenem-Resistant Clusters.
Chaney D, Doucette M, Brandeburg C … +6 more , Cumming M, Bolstorff B, Onofrey S, Fortes E, Epie N, Leaf J
Public Health Rep · 2025 · PMID 40788090 · Full text
OBJECTIVES: Epidemiologic investigations of multidrug-resistant organism (MDRO) clusters depend on a thorough history of health care exposures for case patients; however, histories are often incomplete. We describe how t...
OBJECTIVES: Epidemiologic investigations of multidrug-resistant organism (MDRO) clusters depend on a thorough history of health care exposures for case patients; however, histories are often incomplete. We describe how the robust influx of longitudinal infectious disease surveillance data from the COVID-19 pandemic improved whole-genome sequence-related cluster investigations and validated single nucleotide polymorphism (SNP) cluster definition thresholds for carbapenem-resistant (CRAB) in Massachusetts. METHODS: We used data from infectious disease laboratory test results reported through an integrated person-based surveillance system. We extracted all results from January 1, 2019, through March 19, 2024, for each CRAB case patient in a cluster to identify health care exposures. In addition, we extracted data from epidemiologic investigations. We used data to identify spatial links between cases. We combined timelines with whole-genome sequence data to determine whether genetically related cases were spatially linked. RESULTS: We extracted 2354 test results for 69 CRAB case patients across 9 clusters; 2007 test results were from COVID-19 events. Three-quarters (n = 1775) of test results indicated a health care exposure not identified through standard investigation. Fifty-five case patients had a spatial link with at least 1 other case patient in their cluster. The median number of SNP differences between all spatially linked cases and all non-spatially linked cases was 4 SNPs and 10 SNPs, respectively. PRACTICE IMPLICATIONS: Using longitudinal surveillance data identified possible CRAB transmission events undetected through standard investigation. Comparing the median SNP differences between spatially linked and non-spatially linked cases confirmed that the 10-SNP threshold was appropriate for defining CRAB clusters. Health departments can apply this method to enhance infectious disease investigations and determine appropriate SNP thresholds for infectious disease clusters.
A Survey of Physical and Mental Health Among People Experiencing Homelessness in Denver, Colorado, 2023.
Sherman JP, Drehoff CC, Waddell CJ … +10 more , Callaway PC, Marshall KE, Burakoff A, Herlihy R, Keenan E, Loth Hill J, Laramee N, Cooley D, Sprague B, Hagan LM
Public Health Rep · 2025 · PMID 40767275 · Full text
OBJECTIVES: Homelessness increased by 31% from 2022 to 2023 in Denver, Colorado. We surveyed people experiencing homelessness in Denver to evaluate their health conditions and service needs and to identify factors associ...
OBJECTIVES: Homelessness increased by 31% from 2022 to 2023 in Denver, Colorado. We surveyed people experiencing homelessness in Denver to evaluate their health conditions and service needs and to identify factors associated with new or worsening health conditions after housing loss. METHODS: From October 28 through November 15, 2023, we surveyed 356 people experiencing homelessness in Denver. We fit multivariable logistic regression models using backward-fitting procedures to identify factors associated with reporting new or worsening health conditions after housing loss. RESULTS: The mean (SD) age of participants was 46.0 (13.7) years, 227 (63.7%) reported physical health conditions, and 207 (58.1%) reported mental health conditions that were new or worsening after experiencing homelessness. Chronic pain (n = 61; 17.1%) and depression (n = 123; 34.6%) were the most reported conditions. Eye care (n = 131; 36.8%), dental care (n = 95; 26.7%), and pain management (n = 54; 15.2%) were among the top service needs. Self-rated health declined by 22% after housing loss, from 3.4 (good or very good) before experiencing homelessness to 2.7 (fair or good) at the time of the survey, with a larger decline among those experiencing unsheltered homelessness than among those who were sheltered (0.95 vs 0.57; = .006). As compared with men, women had higher odds of reporting new or worsening health conditions, whether physical (adjusted odds ratio [AOR] = 1.93; 95% CI, 1.14-3.29) or mental (AOR = 2.14; 95% CI, 1.23-3.81). Experiencing violence was associated with reporting new or worsening mental health conditions (AOR = 2.01; 95% CI, 1.20-3.37) after housing loss. CONCLUSION: Targeted interventions are needed to address the unique needs of unhoused women and those experiencing unsheltered homelessness in Denver.
The Men and Women in Blue: A Revealing Perspective.
Giberson RRS
Public Health Rep · 2025 · PMID 40705020 · Full text
Abstract loading — click title to view on PubMed.
Distinguishing Collaboration From Other Group Work to Help Public Health and Other Sectors Solve Wicked Problems to Improve Health and Well-Being for All.
Alderman L, Beck E
Public Health Rep · 2025 · PMID 40686451 · Full text
Public health devotes significant resources to address "wicked" challenges, a term coined nearly 50 years ago to distinguish complex problems from tame problems. Tame problems (eg, building a hospital) may be difficult,...
Public health devotes significant resources to address "wicked" challenges, a term coined nearly 50 years ago to distinguish complex problems from tame problems. Tame problems (eg, building a hospital) may be difficult, but known experts and agreed-upon processes exist to address them. Wicked problems (eg, the obesity epidemic) seem intractable, with no agreed-upon solution or cause. Broad agreement exists that wicked problems require collaboration, especially in periods of hyperuncertainty, marked by the rapid onset of multiple wicked problems and uncertainty. One example of a recent hyperuncertain period occurred in 2020, beginning with major political shifts, followed rapidly by COVID-19, widespread social unrest, and multiple crises from extreme weather events (eg, hurricanes). With collaboration increasing, collaboration scholars lament the lack of broad consensus on what distinguishes collaboration from other group work (eg, coordination). Without a common understanding of and roadmap to build collaboration, public health is limited to address wicked problems. To support effective collaboration, we synthesized 4 decades of scholarship to identify where scholars across 3 related areas of collaboration literature are coalescing on the unique elements required for collaboration. From our synthesis, we created a new definition to distinguish collaboration from other group work, including its requisite key elements that public health can use as guideposts to collaborate effectively. We found no explicit focus on these key elements in the public health collaboration articles reviewed, a gap this article seeks to fill. Longer term, public health agencies and schools can use this work to bolster transdisciplinary collaborative problem-solving capacity.
State Cigarette Taxes and Lung Cancer Incidence, United States, 1970-2019.
Semprini J
Public Health Rep · 2025 · PMID 40663168 · Full text
OBJECTIVES: Although smoking is the leading cause of lung cancer, smoking rates have been declining for decades, in part due to increasing cigarette taxes. This study analyzed how states increased and responded to cigare...
OBJECTIVES: Although smoking is the leading cause of lung cancer, smoking rates have been declining for decades, in part due to increasing cigarette taxes. This study analyzed how states increased and responded to cigarette taxes to determine whether increasing contemporary cigarette taxes could reduce lung cancer incidence in the United States. METHODS: Centers for Disease Control and Prevention data were used to measure state-level cigarette tax and consumption (pack sales per capita). For each state, the elasticity of demand (change in cigarette consumption percentage/change in state tax) was estimated. Then, each state was classified into 4 mutually exclusive groups based on median change in the state cigarette tax from 1970 to 2019 (high, low) and median elasticity (high, low). Finally, state-level, sex-stratified data from the North American Association of Centralized Cancer Registries (2000-2019) were analyzed to test whether the incidence of small cell and squamous cell lung cancer varied by group. RESULTS: From 1970 to 2019, cigarette tax increases ranged from $0.08 (Missouri) to $4.90 (District of Columbia). The median tax increase was $1.54. The elasticity of demand for cigarettes from state taxes ranged from -0.10 (West Virginia) to -0.64 (Georgia). The median elasticity was -0.40. Among males, the low-elasticity, low-tax change group had the highest incidence of small cell and squamous cell lung cancer. No significant differences in incidence were found across groups among females. CONCLUSIONS: Increasing cigarette taxes could reduce the future incidence of lung cancer among males. Other social or environmental policies, however, may be necessary to reduce lung cancer incidence among females.
Writing Beyond the Academic Context: Exploring Writing Among Public Health Practitioners.
Larsson R, Beard J, Norfjord van Zyl M
Public Health Rep · 2025 · PMID 40662384 · Full text
OBJECTIVES: Public health work involves diverse types of writing to communicate health messages to various audiences. Clear, concise, audience-oriented writing is essential, yet public health practitioners often receive...
OBJECTIVES: Public health work involves diverse types of writing to communicate health messages to various audiences. Clear, concise, audience-oriented writing is essential, yet public health practitioners often receive little training in effective writing. This study explores the writing public health practitioners do in their everyday work. METHODS: We emailed a web-based questionnaire in April 2024 to a sample of public health practitioners working in municipalities, regional health departments, governmental agencies, and nongovernmental organizations in 5 regions in Sweden. The questionnaire asked about writing, support, professional development, and writing self-efficacy. We analyzed data using descriptive statistics and content analysis. RESULTS: Seventy-two public health practitioners responded to our questionnaire. The most common types of writing that respondents reported engaging in were presentations (88.9%), reports (59.7%), and decision-making documents (47.2%). Scientific articles (75.0%), blog posts (69.4%), and opinion pieces (56.9%) were the least common. The most common target audiences were politicians, followed by managers and citizens. Colleagues provided the most common source of writing support, followed by communication officers and managers. Most practitioners reported a desire to develop their professional writing skills and achieve high self-efficacy in public health writing. CONCLUSIONS: Public health practitioners in Sweden write more for politicians and managers than for the public. Expanding practitioners' writing skills beyond operational and technical document writing to include public-facing writing will benefit the public health profession by opening communication channels to diverse audiences. Communicating more clearly with public audiences can improve health literacy, promote health for all, and strengthen the effectiveness of public health initiatives.
Prevalence of Receipt of Fluoride Varnish Application in the Medical Setting and Associated Factors Among Children in Indiana, Iowa, and North Carolina, 2013-2022.
Tandon MC, Levy SM, Warren JJ … +6 more , Dabdoub SM, Daly J, Levy BT, Keels MA, Hara AT, Fontana M
Public Health Rep · 2025 Jul · PMID 40662380 · Full text
OBJECTIVE: Fluoride varnish is a prevention measure for dental caries among children, but few studies have assessed its use in medical settings. This study aimed to determine the period-specific and cumulative prevalence...
OBJECTIVE: Fluoride varnish is a prevention measure for dental caries among children, but few studies have assessed its use in medical settings. This study aimed to determine the period-specific and cumulative prevalence of the receipt of fluoride varnish application among children in the medical setting and associated factors. METHODS: A parent study enrolled 1326 primary caregiver/child dyads in Indiana, Iowa, and North Carolina; conducted 6 child dental examinations with primary caregiver questionnaires; and administered intermediate questionnaires every 4 months during 2013-2022. Responses were combined from 2- or 4-month time periods to determine the 1.5-year cumulative rates for children aged 1 to 9.5 years. Researchers conducted bivariate and multivariable logistic regression analyses to assess factors associated with the receipt of fluoride varnish application only from age 1 to 2.5 years. RESULTS: The 18-month cumulative prevalence of the receipt of fluoride varnish application in the medical setting from the child's age of 1 to 2.5 years was 20.4%, and the prevalence decreased to 12.9%, 6.4%, and 1.9% among children aged 2.5 to 4 years, 6.5 to 8 years, and 8 to 9.5 years, respectively. The following factors were significantly positively associated with fluoride varnish application in the medical setting: Medicaid insured, low annual household income, Duke University study site, child's frequent consumption of sugary beverages, child enrolled in other public assistance programs, and child's infrequent dentist visits. CONCLUSIONS: The prevalence of fluoride varnish application in the medical setting is low. Factors associated with the receipt of fluoride varnish can be targeted to increase caries prevention through the expanded use of fluoride varnish application in the medical setting.
Pediatric Routine Immunization Delays in Chicago Before and After the Onset of the COVID-19 Pandemic: A Time-to-Event Analysis.
Faherty EAG, Meininger E, Gorelick S … +2 more , Spencer H, Gretsch S
Public Health Rep · 2025 Jul · PMID 40657718 · Full text
OBJECTIVES: Decreases in routine vaccination have been reported since the COVID-19 pandemic. To identify age groups and vaccine types potentially affected by pandemic disruptions and vaccine hesitancy, we assessed routin...
OBJECTIVES: Decreases in routine vaccination have been reported since the COVID-19 pandemic. To identify age groups and vaccine types potentially affected by pandemic disruptions and vaccine hesitancy, we assessed routine vaccination delays among children in Chicago before and after the onset of the COVID-19 pandemic. METHODS: We used the Illinois Comprehensive Automated Immunization Registry Exchange to estimate the median time to vaccination after eligibility, vaccination incidence rates, and hazard ratios for vaccination of children and adolescents aged ≤18 years vaccinated in 2018-2019 (pre-COVID-19) and 2021-2022 (post-COVID-19 onset). We established 3 age categories: early childhood (0-3 y), childhood (4-6 y), and adolescence (11-18 y). RESULTS: The post-COVID-19 onset cohort had a greater number of median (IQR) days to vaccination than the pre-COVID-19 cohort for adolescent vaccines (249 [86-624] vs 219 [69-614] d). The post-COVID-19 onset cohort had greater median days of delays by dose than the pre-COVID-19 cohort did, specifically for human papillomavirus (HPV) dose 2 (difference of 91 d); HPV dose 3 (52 d); inactivated poliovirus dose 4 (51 d); and diphtheria, tetanus, and acellular pertussis dose 5 and tetanus, diphtheria, and acellular pertussis dose 1 (43 d). In adjusted models, hazards (instantaneous rate of vaccination) were lower for the post-COVID-19 onset cohort than for the pre-COVID-19 cohort, particularly for vaccinations recommended for children aged 4 to 6 years and adolescents, indicating greater postpandemic onset delays for these groups. CONCLUSIONS: Vaccination delays after the COVID-19 pandemic were greatest among children aged 4 to 6 years and adolescents. Clinicians should verify the vaccination status of these groups to prioritize catch-up vaccinations, especially vaccines not required for school or childcare.
Methodology for a COVID-19 Recovery Surveillance Study Conducted Through an Academic-State Partnership.
Hirschtick JL, Xie Y, Whittington B … +5 more , Patel A, Elliott MR, Allgood K, Coyle J, Fleischer NL
Public Health Rep · 2025 Jul · PMID 40641238 · Full text
OBJECTIVE: We describe the methodologic approach to rapidly launching a population-based surveillance study in spring 2020 to examine the lasting physical, mental, and economic effect of COVID-19 among adults in Michigan...
OBJECTIVE: We describe the methodologic approach to rapidly launching a population-based surveillance study in spring 2020 to examine the lasting physical, mental, and economic effect of COVID-19 among adults in Michigan. MATERIALS AND METHODS: We established a partnership between the University of Michigan School of Public Health and the Michigan Department of Health and Human Services to conduct this study. Using a sequential stratified sampling strategy, we randomly selected adults with polymerase chain reaction-confirmed SARS-CoV-2 infection in the Michigan Disease Surveillance System. From 2020 through 2022, respondents completed detailed surveys on the lasting effect of their COVID-19 illness online in English or by telephone in English, Spanish, or Arabic, reflecting the diverse population in Michigan. We created and used sampling weights to reduce survey nonresponse bias and tested the performance of the weights with a nonresponse bias analysis. RESULTS: Of all sampled people (n = 17 584), 5521 completed our baseline survey a median of 4.5 months after their COVID-19 onset, for a response rate of 32.1%. Most respondents completed the survey online in every region except Detroit, where 67.1% completed the survey by telephone, highlighting the importance of multimode surveys to increase accessibility and generalizability. Our findings suggest minimal nonresponse bias in the weighted baseline sample. PRACTICE IMPLICATIONS: This unique academic-state partnership resulted in timely and actionable findings related to the lasting effect of COVID-19 that were unavailable elsewhere. While this effort was successful, it was built out of necessity given the limited resources available to local and state health departments to conduct surveillance during the COVID-19 pandemic.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe